What are the responsibilities and job description for the Appeals Coordinator position at w3r Consulting?
Physical Health Appeals Coordinator
Location: Fully Remote
Schedule: Monday–Friday, 40 hours/week
Type: Contract-to-Hire
Requirement: Mandatory weekend & holiday rotation
Job Summary:
Provide non-clinical support for the Physical Health Appeals Department by assisting members, providers, clinicians, and physicians with appeal-related inquiries and administrative tasks.
Key Responsibilities:
- Handle inbound/outbound calls and respond to member, provider, and physician inquiries.
- Process and distribute physical health appeals to clinical staff.
- Perform data entry, research, documentation, and case management.
- Upload medical information and support external appeal reviews when needed.
- Coordinate work items across departments and resolve issues appropriately.
- Maintain productivity and quality standards.
- Follow HIPAA, confidentiality, compliance, and company policies.
Requirements:
- 1–2 years of college OR 3 years of experience with automated systems.
- Healthcare/insurance experience preferred.
- Knowledge of medical terminology.
- Experience with databases/PC applications.
- Strong customer service, communication, and organizational skills.
- Ability to work required weekend and holiday rotations.